The Patient Centered Medical Home (PCMH)-- The PCMH is a new model for primary care redesign endorsed by the Pediatrics, Internal Medicine and Family Medicine specialty societies as well as many of the major healthcare payers (including the U.S. government).
Heart failure can be ongoing (chronic), or your condition may start suddenly (acute). Heart failure signs and symptoms may include: 1  Shortness of breath (dyspnea) when you exert yourself or when you lie down. 2  Fatigue and weakness. 3  Swelling (edema) in your legs, ankles and feet. 4  Rapid or irregular heartbeat. 5  Reduced ability to exercise. 6  Persistent cough or wheezing with white or pink blood-tinged phlegm.
Most cases involve both sides of the heart. Right-side heart failure occurs if the heart can't pump enough blood to the lungs to pick up oxygen. Left-side heart failure occurs if the heart can't pump enough oxygen-rich blood to the rest of the body. Right-side heart failure may cause fluid to build up in the feet, ankles, legs, liver, abdomen, and the veins in the neck. Right-side and left-side heart failure also may cause shortness of breath and fatigue (tiredness). The leading causes of heart failure are diseases that damage the heart. Examples include coronary heart disease (CHD), high blood pressure, and diabetes.